• Progress in Medical Physics
• /
• v.25 no.4
• /
• pp.199-204
• /
• 2014

The purpose of this study is to evaluate the dosimetric outcome of the field-in-field (FIF) plans compared with tangential wedged beams (TWB) plans for whole breast irradiation of breast cancer patients. Twenty patients with right-sided breast cancer and 10 patients with left-sided breast cancer were retrospectively enrolled in this study. We generated a FIF plan and a TWB plan for each patient to compare dosimetric outcomes. The dose the homogeneity index (HI), the conformity index (CI) and the uniformity index (UI) were defined and used for comparison of the dosimetric outcome of the planning target volume (PTV). To compare the dosimetric outcome of the organs at risk, the mean dose ($D_{mean}$) and the percentage of volumes receiving more than 10, 20 and 30 Gy of the ipsilateral lung and heart were used. The FIF plans had significantly lower HI (p=0.002), higher UI (p=0.000) and CI (p=0.000) than those of the TWB plans, which means that the FIF plans were better than the TWB plans in the dosimetric comparisons of the PTV. The $V10_{lung}$ ($17.1{\pm}7.1$ vs. $18.6{\pm}6.6%$, p=0.020) and $V30_{lung}$ ($10.3{\pm}5.1%$ vs. $10.7{\pm}5.2%$, p=0.000) were lower with the FIF plans compared with those of the TWB plans, with statistical significance. For the left-sided breast cancer patients, $D_{mean}$ of the heart ($2.6{\pm}1.3$ vs. $3.2{\pm}1.4$ Gy, p=0.000), $V20_{heart}$ ($3.4{\pm}2.6$ vs. $3.6{\pm}2.8%$, p=0.005) and $V30_{heart}$ ($2.6{\pm}2.3%$ vs. $2.9{\pm}2.4%$, p=0.004) were significantly lower for the FIF plans in comparison with those of the TWB plans. The FIF plans increased the dose homogeneity, conformity and uniformity of the target volume for the whole-breast irradiation compared with the TWB plans. Moreover, FIF plans reduced the doses to the ipsilateral lung and heart.

• Journal of radiological science and technology
• /
• v.36 no.3
• /
• pp.237-244
• /
• 2013

The purpose of this study is to compare method in the treatment of breast cancer using dose index. And, it is to find the optimized treatment technique to the patient. The phantom filled with tissue-equivalent material were used simulation and treatment as techniques of 3D-CRT, IMRT, VMAT was planned using Eclipse v10. By using HI(homogeneity index), CI(Conformity index), OED(Organ equivalent dose), EAR(Excess Absolute Risk), were assessed for each treatment plans. HI and CI of 3D-CRT, IMRT, VMAT were calculated 16.89, 11.21, 9.55 and 0.59, 0.61, 0.83. The organ average doses of Lt lung, Rt lung, liver, heart, esophagus, cord, Lt breast, trachea and stomach were 0.01 ~ 2.02 Gy, 0.36 ~ 5.01 Gy, 0.25 ~ 2.49 Gy, 0.14 ~ 6.92 Gy, 0.03 ~ 2.02 Gy, 0.01 ~ 1.06 Gy, 0.25 ~ 6.08 Gy, 0.08 ~ 0.59 Gy, 0.01 ~ 1.34 Gy, respectively. The OED, EAR of the IMRT and VMAT show higher than 3D-CRT. As the result of this study, we could confirm being higher dose index(HI, CI) in IMRT and VMAT than 3D-CRT, but doses of around normal organs was higher IMRT, VMAT than 3D-CRT.

• Progress in Medical Physics
• /
• v.25 no.4
• /
• pp.242-247
• /
• 2014

To see the discrepancies between the calculated and the delivered dose distribution of IMRT fields for respiratory-induced moving target according to the motion ranges. Four IMRT plans in which there are five fields, for lung and liver patients were selected. The gantry angles were set to $0^{\circ}$ for every field and recalculated using TPS (Eclipse Ver 8.1, Varian Medical Systems, Inc., USA). The ion-chamber array detector (MatriXX, IBA Dosimetry, Germany) was placed on the respiratory simulating platform and made it to move with ranges of 1, 2, and 3 cm, respectively. The IMRT fields were delivered to the detector with 30~70% gating windows. The comparison was performed by gamma index with tolerance of 3 mm and 3%. The average pass rate was 98.63% when there's no motion. When 1.0, 2.0, 3.0 cm motion ranges were simulated, the average pass rate were 98.59%, 97.82%, and 95.84%, respectively. Therefore, ITV margin should be increased or gating windows should be decreased for targets with large motion ranges.

• Radiation Oncology Journal
• /
• v.20 no.2
• /
• pp.172-178
• /
• 2002

Purpose : X-ray film over responds to low-energy photons in relative photon beam dosimetry because its sensor is based on silver bromide crystals, which are high-Z molecules. This over-response becomes a significant problem in clinical photon beam dosimetry particularly in regions outside the penumbra. In intensity modulated radiation therapy (IMRT), the radiation field is characterized by multiple small fields and their outside-penumbra regions. Therefore, in order to use film dosimetry for IMRT, the nature the source of the over-response in its radiation field need to be known. This study is aimed to verify and possibly improve film dosimetry for IMRT. Materials and Method : Modulated beams were constructed by a combination of five or seven different static radiation fields using 6 MeV X-rays. In order to verify film dosimetry, we used X-ray film and an ion chamber were used to measure the dose profiles at various depths in a phantom. In addition, in order to reduce the over-response, 0.01 inch thick lead filters were placed on both sides of the film. Results : The measured dose profiles showed a film over-response at the outside-penumbra and low dose regions. The error increased with depths and approached 15% at a maximum for the field size of $15{\times}15cm^2$ at 10 cm depth. The use of filters reduced the error to 3%, but caused an under-response of the dose in a perpendicular set-up. Conclusion : This study demonstrated that film dosimetry for IMRT involves sources of error due to its over-response to low-energy Photons. The use of filers can enhance the accuracy in film dosimetry for IMRT. In this regard, the use of optimal filter conditions is recommended.

• Progress in Medical Physics
• /
• v.17 no.1
• /
• pp.6-16
• /
• 2006

The goal of this study was to develop new indices for effectively evaluating the dose coverage and homogeneity based on the target-volume dose-volume histogram (TV-DVH) of intensity-modulated radio-therapy treatment plans. A new coverage Index and a new homogeneity index were developed by integrating a modified TV-DVH and by fitting a TV-DVH with a modified step function, respectively. The coverage index, named the l-index, indicates whether the dose coverage for the target volume is adequate based on user-defined criteria. A lower l-index indicates higher dose coverage of the tumor volume. The index for assessing dose homogeneity in a target volume, named the n-index, is more accurate than the conventional method in evaluating the dose homogeneity in a tumor volume. The baseline treatment plan for a target volume coverage and homogeneity is discussed. The proposed simple indices have been demonstrated to be effective in evaluating the dose coverage and homogeneity for TV-DVHs.